Clinicopathologic and immunophenotypic features of eosinophilic fasciitis and morphea profunda: A comparative study of 27 cases

Oluwakemi Onajin, Carilyn N. Wieland, Margot S. Peters, Christine M. Lohse, Julia Lehman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background Eosinophilic fasciitis (EF) and morphea profunda (MP) are inflammatory and sclerosing disorders of the subcutis that can exhibit clinical and pathologic presentations that overlap. Objective To identify clinicopathologic features that can be used to distinguish EF from MP. Methods We performed a retrospective review of 16 patients with EF and 11 patients with MP. Hematoxylin-eosin, CD123, CD34, and Verhoeff-Van Gieson stains were evaluated on skin biopsies that included the fascia. Results EF patients were more likely than MP patients to be men (P =.047), have forearm involvement (P =.003), and have peripheral eosinophilia (P <.01). Compared with MP patients, patients with EF were more likely to have fascia that contained eosinophils (P =.003), although eosinophils were absent in 3 (19%) patients with EF. Focal absence of CD34 staining was more prominent in the fascia of EF patients (P =.04). The extent of Verhoeff-Van Gieson staining did not differ between the 2 groups. Dermal sclerosis was not detected in many cases of EF and MP (56% and 36%, respectively). Limitations This was a retrospective study at a single institution. Conclusion Although EF and MP share clinical and pathologic features, our results indicate that the presence of eosinophils in the blood and fascia and focal loss of CD34 staining might be more suggestive of EF than MP.

Original languageEnglish (US)
Pages (from-to)121-128
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume78
Issue number1
DOIs
StatePublished - Jan 1 2018

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Localized Scleroderma
Fascia
Eosinophils
Staining and Labeling
Eosinophilic Fasciitis
Skin
Eosinophilia
Sclerosis
Hematoxylin
Eosine Yellowish-(YS)
Forearm
Coloring Agents
Retrospective Studies

Keywords

  • dermatopathology
  • eosinophilic fasciitis
  • eosinophils
  • histopathology
  • immunohistochemistry
  • morphea profunda
  • sclerosing disorder

ASJC Scopus subject areas

  • Dermatology

Cite this

Clinicopathologic and immunophenotypic features of eosinophilic fasciitis and morphea profunda : A comparative study of 27 cases. / Onajin, Oluwakemi; Wieland, Carilyn N.; Peters, Margot S.; Lohse, Christine M.; Lehman, Julia.

In: Journal of the American Academy of Dermatology, Vol. 78, No. 1, 01.01.2018, p. 121-128.

Research output: Contribution to journalArticle

Onajin, Oluwakemi ; Wieland, Carilyn N. ; Peters, Margot S. ; Lohse, Christine M. ; Lehman, Julia. / Clinicopathologic and immunophenotypic features of eosinophilic fasciitis and morphea profunda : A comparative study of 27 cases. In: Journal of the American Academy of Dermatology. 2018 ; Vol. 78, No. 1. pp. 121-128.
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AB - Background Eosinophilic fasciitis (EF) and morphea profunda (MP) are inflammatory and sclerosing disorders of the subcutis that can exhibit clinical and pathologic presentations that overlap. Objective To identify clinicopathologic features that can be used to distinguish EF from MP. Methods We performed a retrospective review of 16 patients with EF and 11 patients with MP. Hematoxylin-eosin, CD123, CD34, and Verhoeff-Van Gieson stains were evaluated on skin biopsies that included the fascia. Results EF patients were more likely than MP patients to be men (P =.047), have forearm involvement (P =.003), and have peripheral eosinophilia (P <.01). Compared with MP patients, patients with EF were more likely to have fascia that contained eosinophils (P =.003), although eosinophils were absent in 3 (19%) patients with EF. Focal absence of CD34 staining was more prominent in the fascia of EF patients (P =.04). The extent of Verhoeff-Van Gieson staining did not differ between the 2 groups. Dermal sclerosis was not detected in many cases of EF and MP (56% and 36%, respectively). Limitations This was a retrospective study at a single institution. Conclusion Although EF and MP share clinical and pathologic features, our results indicate that the presence of eosinophils in the blood and fascia and focal loss of CD34 staining might be more suggestive of EF than MP.

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